<div class="container">

			<div class="row">

				<div class="span9">
					<div class="register">
						<div id="resultMsg" class="">
							<?php 
							if(isset($_REQUEST['result'])) {
								if($_REQUEST['result'] ==1) {
									print '<h4 style="color:#468847">Accuont Created successfully</h4><br><br>';	
								} else {
									print '<h4 style="color:#CC0000">Error Creating Accuont</h4><br><br>';
								}
							}
							?>
						</div>
						<div class="titleHeader clearfix">
							<h3>Create New Account</h3>
						</div><!--end titleHeader-->

						<form method="post" action="user/signup" class="form-horizontal">

							<h4>&nbsp;&nbsp;&nbsp;&nbsp;1. Personal Informations</h4>

							<div class="control-group">
							    <label class="control-label" for="inputFirstName">First Name: </label>
							    <div class="controls">
							      <input type="text" id="inputFirstName" placeholder="First Name" name="first_name">
							    </div>
							</div><!--end control-group-->

							<div class="control-group">
							    <label class="control-label" for="inputLastName">Last Name: </label>
							    <div class="controls">
							      <input type="text" id="inputLastName" placeholder="Last name" name="last_name">
							    </div>
							</div><!--end control-group-->

							<div class="control-group">
							    <label class="control-label" for="inputEMAdd">E-Mail Address: </label>
							    <div class="controls">
							      <input type="text" id="inputEMAdd" placeholder="example@example.com" name="email">
							    </div>
							</div><!--end control-group-->

							<div class="control-group">
							    <label class="control-label" for="inputTele">Phone: </label>
							    <div class="controls">
							      <input type="text" id="inputTele" placeholder="(02)-1598-548" name="phone">
							    </div>
							</div><!--end control-group-->

							<h4>&nbsp;&nbsp;&nbsp;&nbsp;2. Address Informations</h4>

							<div class="control-group">
							    <label class="control-label" for="inputFirstAdd">Address: </label>
							    <div class="controls">
							      <input type="text" id="inputFirstAdd" placeholder="floor, bldg, street, city, country" name="address">
							    </div>
							</div><!--end control-group-->


							<div class="control-group">
							    <label class="control-label" for="inputCity">City: </label>
							    <div class="controls">
							      <input type="text" id="inputCity" placeholder="Email" name="city">
							    </div>
							</div><!--end control-group-->

							<div class="control-group">
							    <label class="control-label" for="inputPostCode">Post Code: </label>
							    <div class="controls">
							      <input type="text" id="inputPostCode" placeholder="12345" name="postal_code">
							    </div>
							</div><!--end control-group-->

							<div class="control-group">
							    <div class="control-label">Contury: </div>
							    <div class="controls">
							      <input type="text" id="inputCountry" placeholder="Country" name="country">
							    </div>
							</div><!--end control-group-->

							<h4>&nbsp;&nbsp;&nbsp;&nbsp;3. Set Your Password</h4>

							<div class="control-group">
							    <label class="control-label" for="inputPass">Password: </label>
							    <div class="controls">
							      <input type="password" id="inputPass" placeholder="**********" name="password">
							    </div>
							</div><!--end control-group-->

							<div class="control-group">
							    <label class="control-label" for="inputConPass">Re-Type Password: </label>
							    <div class="controls">
							      <input type="password" id="inputConPass" placeholder="**********" name="password2">
							    </div>
							</div><!--end control-group-->

							<hr>

							<div class="control-group">
							    <div class="controls">
								    <button type="submit" class="btn btn-primary" name="user_signup_submit" value="1">Register</button>
							    </div>
							</div><!--end control-group-->

						</form><!--end form-->

					</div><!--end register-->
				</div><!--end span9-->

			</div><!--end row-->

		</div><!--end conatiner-->